The present invention is directed to apparatus, systems, equipment and methods for heart bypass surgery.
In heart surgery, the patient""s sternum is often spread using a surgical retractor. This allows the surgeon access to the patient""s heart to perform the necessary procedures. An example of a prior art surgical retractor is given in Koros, et al., U.S. Pat. No. 5,167,223, which is incorporated herein by reference.
In beating heart surgery, the surface of the heart must be stabilized to perform surgical procedures such as bypass graphs. Often, a stabilizing fork which is attached to a surgical retractor is used to stabilize the surface of the heart. Because the heart is a pulsatile contractive muscle, the area for which the bypass is to be performed must be stabilized to allow the surgeon to suture the bypass graph to the target artery.
For some procedures, the current stabilizing fork cannot be properly placed to provide sufficient stabilization of the surgical site. Generally this is so where the target artery is located on the back side of the heart and the heart must be rotated and stabilized. Stabilization forks are not designed to rotate or hold the heart in a rotated position. For this reason, in practice, the stabilizer fork is often removed from the surgical retractor by a surgical assistant and held manually in position on the surface of the heart. A problem with this method is that it places another person within the surgical field, thereby limiting the amount of space the surgeon has available to perform the desired surgical procedures. Devices such as the Octopus from CTS, have been designed to hold the heart in a rotated position and provide stabilization of the surgical site, though they are complicated to set up and require constant attention throughout the procedure.
It is desired to have an improved methods and apparatus for positioning and stabilizing the heart during heart surgery.
The present invention provides apparatus systems and methods which enable heart surgery on all vessels of the heart, but especially on the less accessible lateral and posterior vessels of the heart.
In one embodiment the present invention comprises a stabilizing apparatus that allows for a stabilizing element to apply force from inside the surgical space. In a preferred embodiment, a support is connected to a surgical retractor and positioned within the surgical space. A jack connected to the support is extended so that a stabilizing element at the end of the jack can contact the heart with a sideways, rather than a downward, force on the heart. This provides sufficient stabilizing force for lateral and posterior vessels of the heart.
Another embodiment of the present invention comprises an elastic band that wraps around the heart. Lines attached to the band can be manipulated to maneuver and rotate the heart so as to provide surgical access to the lateral and posterior vessels of the heart. In one embodiment, the lines can be sent to a rotatable assembly to maneuver the band.
Another embodiment of the present invention comprises fingers that can be attached to the bottom of a blade on a retractor arm. The fingers are attached so that they can rotate outward. These fingers can be used to manipulate the heart during heart surgery.